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Health Care Case Study

Case #3950: Supervisory and Management Training - HMO Organization

A large Health Insurance Company formed a subsidiary Health Maintenance Organization (HMO) by combining four regional HMOs. The workforce of the new organization was unionized to reflect the work environment of its parent company. The resulting organization had undergone several changes in leadership and was losing membership. The organization had operated at a loss for several successive years, and was scheduled to implement a new processing system (Facets) in a few months.

Client management realized that in order to return to profitability and prepare for the implementation of the Facets system, unit productivity would need to improve and supervisory personnel would have to be trained in production management techniques. We were engaged to train supervisors to manage in a production environment and in the development and application of work standards.

The resulting Work Standards and Supervisory Training Initiative focused on training, mentoring and coaching supervisors in standards development, work management, process improvement, workload quantification and in the use of production tracking systems.

Engagement Highlights

  • Industry:
  • Health Insurance and Managed Care
  • Client:
  • A recently formed HMO subsidiary of a Leading Health Insurance Company
  • Assignment:
  • Identify and review workload generators
  • Train supervisors to conduct observations and establish reasonable expectancies (REs)
  • Establish example REs in Claims, Customer Service and Rating & Underwriting
  • Provide validation of existing standards in Membership and Care Management
  • Prepare individual development plans for 28 supervisors
  • Prepare and conduct supervisory development workshops
  • Provide mentoring and floor coaching to each of the 28 supervisors
  • Assist the company in training personnel on its proprietary production tracking system
  • Approach:
  • Apply self-assessment instruments
  • Work with client to develop and conduct classroom seminars
  • Provide floor coaching and mentoring on individual basis to 28 supervisors
  • Duration:
  • 9 Calendar Weeks

Results

  • Supervisors trained in production management techniques
  • Several dozen process improvement opportunities identified
  • Excess capacity identified and quantified in all areas
  • Standards identified that were up to 400% too low

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